Ultraschall Med 2013; 34 - WS_SL20_04
DOI: 10.1055/s-0033-1354929

Prognostic significance of MCP-1 and intensive ultrasound follow up in early postoperative carotid restenosis

I Strenja Linic 1, M Kovacevic 2, S Kovacic 3, I Sosa 4, Z Trobonjaca 5, S Dvornik 6
  • 1Clinical Hospital Rijeka, Cerebrovascular Clinic, Department of Neurology, Rijeka, Croatia
  • 2Clinical Hospital Centre Rijeka, Thoracovascular Surgery Clinic, Department of Surgery, Rijeka, Croatia
  • 3Clinical Hospital Centre Rijeka, Department of Radiology, Rijeka, Croatia
  • 4Rijeka University Medical Faculty, Department of Forensic Medicine and Criminalistics, Rijeka, Croatia
  • 5Rijeka University Medical School, Department of Physiology and Immunology, Rijeka, Croatia
  • 6Clinical Hospital Centre Rijeka, Clinical Department of Laboratory Diagnostic, Rijeka, Croatia

Introduction: Early screening of patients with carotid artery stenosis as well as postoperative ultrasound follow up of thrombendarterectomy (CEA) treatment is paramount in primary and secondary prevention of stroke.

Research aim: Monocyte chemotactic protein (MCP-1) are of great significance in this process, therefore we can put MCP-1 as one of the earliest signs of endothelial dysfunction. We attempted to ascertain the prognostic value of determining MCP-1 in system circulation with the purpose of early screening and discovery of patients with a high risk of carotid restenosis.

Patients and methods: In our study we included 75 patients with carotid artery stenosis. All patients with carotid artery stenosis were divided into two groups according to clinical manifestations: a) asymptomatic, (45 patients) and b) symptomatic (30) patients. After CEA we scheduled an ultrasonographic follow up according to a 7, 30 and 90 day after CEA algorithm in order to early discover developing carotid artery restenosis. MCP-1 serum levels have been determined using ELISA method and a procedure where we implemented follow up according to a 0, 2 and 90 day after CEA algorithm.

Results: A statistically significant difference between stenosis and restenosis groups has been determined. The groups were divided into subgroups according to MCP-1 plasma levels found on day 0 (before CEA) χ2= 4.66; p = 0.031 and on day 90 after CEA χ2= 4.66; p = 0.031.

Conclusion: With these results we verified a key hypothesis of this study in confirming a prognostic value of determining serum MCP-1 levels combined with Doppler ultrasonographic follow up in patients prior and after CEA. Now we can recognize potential for restenosis in patients with carotid artery stenosis and implement intensive combined follow up both before and after CEA